title: Biomass fuel use and the risk of asthma in Nigerian children.
abstract: BACKGROUND
  Biomass fuel smoke exposure contributes to respiratory infections in childhood, but its association with asthma has not been established. We studied the relationship of biomass fuel use with asthma symptoms and lung function in Nigerian children.
  
  
  METHODS
  A cross-sectional study was performed in 299 village children aged 5-11 years in North Central Nigeria. Data were collected regarding the cooking fuels used and duration of daily smoke exposure in the cooking area. Asthma symptoms were assessed with a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and lung function was assessed with spirometry.
  
  
  RESULTS
  The prevalence of a lifetime history of wheeze was 9.4% (95% CI: 6.3%-13.2%). Fourteen children (4.7%) had airway obstruction (FEV1/FEV6 <85%). Female subjects had lower FEV1 and FEV6 (110 % and 120% percent predicted, respectively) than males (121% and 130%, respectively, P <0.001 for both differences). Advancing age was associated with a relative decline in the predicted value of FEV1 of 7.8 % per year (r = -0.61; P < 0.001). Children in families that used firewood daily did not have a significantly increased likelihood of asthma-related symptoms (OR = 2.36, 95% CI: 0.66-8.44). Similarly, airway obstruction did not differ significantly between children in households that did and did not use firewood daily (mean FEV1/FEV6 of 0.95 and 0.97, respectively; P = 0.41).
  
  
  CONCLUSIONS
  Reported smoke exposure was not associated with an increased risk of asthma symptoms or airway obstruction. However, lifetime smoke exposure may explain the reduction in spirometric values in female subjects and with advancing age.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Nobels Väg 13, 17177 Stockholm, Sweden. Electronic address: jesse.thacher@ki.se.
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Thacher
authors.forename: Anders
authors.initials: A
authors.lastname: Emmelin
authors.forename: Aboi J K
authors.initials: AJ
authors.lastname: Madaki
authors.forename: Tom D
authors.initials: TD
authors.lastname: Thacher
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D056804:Biofuels / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012135:Respiratory Sounds / Q000502:physiology; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects*
chemical_list: D056804:Biofuels; D012906:Smoke
keywords: Africa; Epidemiology; Indoor air pollution; Lung volume measurements